From the United States to Uganda, Grand Rounds Goes Global

Dr. Jeffrey Sachs

On Thursday, June 12, 2014, there was a global feel to medicine grand rounds at Montefiore, Einstein's University Hospital, when Dr. Jeffrey Sachs, director of the Earth Institute at Columbia University, delivered his talk, "Health for All, or Why Health is Not a Market Commodity."

World renowned for his work in economic development and the fight against poverty, Dr. Sachs poignantly noted that, despite higher healthcare costs relative to other high-income countries such as Canada, the United Kingdom and Sweden, the United States ranks poorly in life expectancy and health equity. "This paradox comes from a misclassification in our society of treating healthcare as a market commodity and not as a public service," he explained. "Organizing healthcare in this way will never serve the purpose of ensuring health for all."

He continued, "Healthcare in the United States costs approximately $8,000 per person, per year. One cause of these high costs is the varied, and often hidden, price of comparable services."

"All payers in a hospital should pay the same price for the same service," he recommended. "I think it could drive down healthcare costs considerably." He then challenged the audience to design a comprehensive primary healthcare system in New York City that would cost $5,000 per person, per year.

Dr. Sachs' grand rounds presentation was organized by Jill Raufman, manager of Einstein's Global Health Center and director of medical student global health programs, in conjunction with Dr. Gerald Paccione, professor of clinical medicine at Einstein and attending physician in internal medicine at Einstein's University Hospital, Montefiore Medical Center. "Dr. Sachs has been instrumental in driving home the message that health is dependent on economic development and that economic development depends on people's health," noted Dr. Paccione, who introduced Dr. Sachs to the standing room only audience.

Following his presentation, Dr. Sachs met with Montefiore residents and fourth-year Einstein medical students who will soon be leaving to start their Global Health Fellowships in Kisoro, Uganda with Dr. Paccione. Joining him during this roundtable discussion was his wife, Dr. Sonia Sachs, a pediatrician who directs the African Millennium Villages Project in partnership with the Earth Institute and the United Nations (U.N.).

"Hearing about health from an economist's point of view, especially someone like Jeff Sachs, who directed the work on the Millennium Development Goals, helps to broaden students' and residents' perspective on where they will be working and what they will be doing, which makes it a much richer learning experience," said Ms. Raufman.

Dr. Sachs also is Quetelet Professor of Sustainable Development and professor of health policy and management at Columbia University. And, he serves as a special advisor to U.N. Secretary-General Ban Ki-moon on the Millenium Development Goals, and as director of the U.N. Sustainable Development Solutions Network.